Balloon protection and rewrapping devices and related methods of use

ABSTRACT

A movable protection and/or rewrapping device for a balloon catheter may include a tubular member with a bore extending along a length thereof. The tubular member may have at least one rib disposed on an inner surface of the bore. The tubular member may be flared away from the bore at one end and inwardly tapered at the other end. The rewrapping device may include an actuator configured to open a longitudinal slit in the tubular member.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority under 35 U.S.C. § 119 to U.S. Provisional Application Ser. No. 61/935,696, filed Feb. 4, 2014, the entirety of which is incorporated herein by reference.

FIELD

Embodiments of the present disclosure are broadly directed to balloon catheters. In particular, the disclosure relates to devices, systems and methods for protecting and/or wrapping or rewrapping balloon catheters.

BACKGROUND

Certain treatments require temporary or permanent interruption or modification of select nerve function. One example treatment is renal nerve ablation, which is sometimes used to treat conditions related to congestive heart failure. Some of the known renal denervation systems use a catheter shaft having a balloon coupled to its distal end for ablation. Renal denervation procedures involve contra-lateral application of therapy targeting both right and left renal artery. In some scenarios, same balloon may be used to provide treatment to both the right and left renal artery.

Typically balloons usually have flex circuits with one or more pairs of electrodes and temperature sensors disposed on the balloon, to deliver RF energy to a target nerve. Once unwrapped and used it becomes difficult to rewrap the balloon to its original profile for re-use at a new treatment site. Also, the balloon does not have enough column strength to reinsert the balloon through a hemostasis valve without damaging the balloon.

Drug coated balloons are packaged with a protection device over the balloon, however the protection device must be removed prior to loading the balloon catheter onto a guide wire or into a guide catheter. Handling the balloon may result in disruption of the drug coating. Additionally, the balloon may not have enough column strength to insert the balloon through a hemostasis valve without damaging the balloon and disrupting the drug coating.

Hence, there exists a need of for a device to protect a balloon during use and to aid insertion and/or rewrapping and re-insertion of the balloon through a hemostasis valve.

SUMMARY

In one embodiment, the present disclosure may include a removable protection device for a balloon catheter. The removable protection device may include a tubular member, and at least one rib. The tubular member may include a bore extending along a length thereof. The tubular member may be flared away from the bore at one end. The rib may extend along an inner surface of the bore.

In another embodiment, the present disclosure may include a laterally removable protection and/or rewrapping device for a balloon catheter. The lateral removable protection and/or rewrapping device may include a tubular member and an actuator. The tubular member may have a first end, a second end, and a bore that may extend between the first end and the second end. The tubular member may also include a slit extending from the first end to the second end. The tubular member may further include a hinge region opposite the slit. The bore may have a shaped inner surface that may be configured to rewrap a deflated balloon with two or more folds. The actuator may be configured to expand the slit thereby allowing the tubular member to be inserted laterally over a catheter shaft.

In another embodiment, the present disclosure may include a method of inserting a balloon through a hemostasis valve. The method includes providing a catheter shaft having a proximal end and a distal end, and an expandable balloon disposed on the distal end, the balloon being in a deflated configuration, moving a protection device onto the balloon, the protection device including a tubular member having a first end, a second end, a bore extending therebetween, and an inward taper at the second end, guiding the distal end of the catheter shaft and balloon into the hemostasis valve by inserting the tapered second end of the protection device at least partially into the hemostasis valve, and removing the protection device from the hemostasis valve.

In another embodiment, the present disclosure may include a method of rewrapping a deflated balloon. The method includes providing a catheter shaft having a proximal end and a distal end and an expandable balloon disposed on the distal end. The method may also include expanding the balloon and then deflating the balloon. The method may further include providing a rewrapping device and moving the rewrapping device distally over the catheter shaft and onto the balloon thereby rewrapping the balloon. The rewrapping device may include a tubular member having a bore that may extend along a length thereof, and at least one rib extending along an inner surface of the bore.

The above summary of some embodiments is not intended to describe each disclosed embodiment or every implementation of the present disclosure. The figures, and detailed description, which follow, more particularly exemplify these embodiments, but are also intended as exemplary and not limiting.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a removable protection and rewrapping device, in accordance with an aspect of the present invention;

FIG. 2 is a perspective view of the removable protection and rewrapping device of FIG. 1 taken from a flared end;

FIG. 3 is a side view of the removable protection and rewrapping device of FIG. 1;

FIG. 4 is a perspective view of another removable protection and rewrapping device, in accordance with the present disclosure;

FIG. 5 is a view of the removable protection and rewrapping device of FIG. 4 taken from a flared end;

FIG. 6 is a side view of a removable protection and rewrapping device, in accordance with another aspect of the present disclosure;

FIG. 7 is a perspective view of the removable protection and rewrapping device of FIG. 6, in accordance with an aspect of the present disclosure;

FIG. 8 is a front view of the removable protection and rewrapping device of FIG. 7 taken from the flared end;

FIG. 9 is a perspective view of a removable protection and rewrapping device, in accordance with another aspect of the present disclosure;

FIG. 10 is a front view of the removable protection and rewrapping device of FIG. 9 taken from the flared end;

FIG. 11 is perspective view of a removable protection and rewrapping device, in accordance with yet another aspect of the present disclosure;

FIG. 12 is front view of the removable protection and rewrapping device of FIG. 11 from the flared end; and

FIGS. 13A and 13B are elevational views illustrating inserting a balloon catheter into a hemostasis valve with one example of a protection device.

While embodiments of the present disclosure are amenable to various modifications and alternative forms, specifics thereof have been shown by way of example in the drawings and will be described in detail. It should be understood, however, that the intention is not to limit aspects of the disclosure to the particular embodiments described. On the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the present disclosure.

DETAILED DESCRIPTION

Renal denervation procedures usually involve bilateral or contralateral treatment. In such scenarios, a catheter shaft may be used to perform the procedure. The catheter shaft may have a proximal end, distal end and may further include a balloon disposed at the distal end of the catheter shaft.

An introduction sheath may be deployed through an entry point within a first body lumen (e.g., right renal artery) to guide the catheter shaft to a treatment site. A hemostasis valve may be coupled to the introduction sheath to prevent blood leak and/or accidental fluid flow from the entry point. The catheter shaft may be advanced into the introduction sheath through the hemostasis valve to the treatment location where the balloon may be inflated. Once the procedure is performed, the balloon may be deflated and the catheter shaft may be retracted from the introduction sheath. Then, the introduction sheath may be deployed within a second body lumen (e.g., left renal artery) to perform a similar procedure. The catheter shaft used for treating the first body lumen needs to be reinserted into the introduction sheath through the hemostasis valve, and this may require the deflated balloon to be wrapped to a profile that can be easily passed through the hemostasis valve without damaging the balloon.

In some treatment procedures, two different sized balloons may be required, for example, a 7 mm balloon may be used to treat a main artery and then a 3 mm or 4 mm balloon may be used to treat the accessory artery. After treating one side, the 7 mm balloon is then used to treat the second side main artery, followed again by the 3 mm or 4 mm balloon for the second accessory artery. If the balloons cannot be successfully refolded, new balloons may be needed for the second part of the procedure.

In other treatment procedures, balloons having a surface coating including active pharmaceutical ingredients (APIs) and excipients may require handling by the user during loading of the balloon catheter into a guide catheter or onto a guide wire. The drug coated balloon is generally packaged with a protection device over the coated balloon, however this protection device is removed before the drug coated balloon can be loaded onto a guide wire. The drug coating may be disrupted when the drug coated balloon is handled by the user.

In view of the above situations and concerns, the present disclosure provides balloon protection and/or rewrapping devices to protect and/or rewrap the deflated balloon such that the balloon can be rewrapped with suitable folds without being damaged. Also, the device may assist in protection of the balloon during insertion through the hemostasis valve. The protection/rewrapping device may also protect the user from contact with an API including substances with potentially adverse side effects, such as paclitaxel. The protection/rewrapping device may be removed once the balloon is advanced.

FIG. 1 is a perspective view of a laterally removable protection/rewrapping device 100. In some embodiments, the laterally removable device 100 may be disposed laterally over a drug coated balloon to provide protection to the balloon and to provide a means of handling the balloon without disrupting the drug coating. In other embodiments, the device 100 may be disposed laterally over a catheter at a location proximal to a deflated balloon and then the device 100 may be advanced over the deflated balloon to aid in rewrapping the deflated balloon.

The laterally removable protection/rewrapping device 100 may include a tubular member 102 having a first end 104 and a second end 106. One end of the tubular member 102 may be flared outwardly. In some examples, the flared end 105 of the tubular member 102 may allow movement of the balloon through the tubular member 102 preventing any accidental damage to the balloon or the catheter shaft. In some examples, one end of the tubular member 102 may have an inward taper 103. The taper 103 may aid in inserting the balloon catheter into a hemostasis valve. The taper 103 may be configured to be partially inserted into the valve, such that the device 100 may be used to grasp and handle the balloon and insert it into the valve, providing protection to the balloon and any coating on the balloon.

The tubular member 102 may define a bore 108 such that the bore 108 may be a tube-like channel extending along a longitudinal length of the tubular member 102. The bore 108 may receive the catheter shaft and/or deflated balloon (not shown).

The bore 108 may include a shaped inner surface configured to rewrap a deflated balloon with two or more folds. In some embodiments, the tubular member 102 may be suitably dimensioned to receive the catheter shaft such that an inner diameter of the tubular member 102 may be almost equal to a profile of the catheter shaft. In other embodiments, the tubular member 102 may have the inner diameter relatively smaller than that of the profile of catheter shaft such that the catheter shaft and/or the balloon may be compressed within the bore 108 of the tubular member 102 thereby engaging and securing the catheter shaft and/or the balloon within the tubular member 102 before insertion.

As shown in FIG. 2, the bore 108 of the tubular member 102 may have a cross-section that is substantially circular. It is contemplated that the bore 108 may also have an ovoid cross-section. In some embodiments, the bore 108 may possess a triangular cross-section with three arcuate surfaces that may fold the balloon forming a three wing fold. In some embodiments, the bore 108 may be a substantially X-shaped cross-section such that the balloon may be folded with four wings. In other embodiments, the bore 108 may have a star shaped cross-section such that the balloon disposed within the bore 108 may be folded forming five wings.

The inner surface of the tubular member 102 defined by the bore 108 may include a coating (not shown) of lubricious material in order to allow smooth passage of the balloon and/or the catheter shaft. Examples of such materials may include polymers such as, but not limited to, PTFE, FEP, or the like.

The tubular member 102 may further include a slit 110 defined along the longitudinal length of the tubular member 102. The slit 110 may enable the tubular member 102 to receive the catheter shaft laterally (i.e., by side-loading) by transitioning the tubular member 102 between an open and a closed configuration. To enable the tubular member 102 transition between the open and the closed configuration, the tubular member 102 may include a hinge region 112 formed opposite the slit 110. The laterally removable rewrapping device may also include an actuator 114 proximate the hinge region 112 configured to expand the slit 110, thereby opening the tubular member 102. The hinge region 112 may include a scored line, partial cut, or thinned region extending longitudinally along the tubular member 102 opposite the slit 110. The actuator 114 may include a first tab 116 and a second tab 118 arranged such that when the user moves the first tab 116 and the second tab 118 towards each other, the slit 110 expands, thereby opening the tubular member 102. The first tab 116 and the second tab 118 may be spaced apart and extend radially away from the tubular member 102, as shown in FIG. 2.

The first tab 116 and the second tab 118 may have a circular structure to provide a surface for the user's fingers to grasp the tabs 116, 118 easily. To facilitate a firm grip, the first tab 116 and the second tab 118 may have a pattern formed on an outer surface of the first tab 116 and the second 118. The pattern may include grooves, lines, micro-protrusions, or the like. In some embodiments, the first tab 116 and the second tab 118 may have shape such as rectangular, square, oval, or the like with smooth edges to prevent any accidental damage to the user. The first tab 116 and the second tab 118 may be made of any suitable material, for example, a plastic or polymer, such as, silicone, polyvinylchloride, polyurethane, or the like; a metal or alloy, such as titanium or titanium alloys, nickel, aluminum, stainless steel, copper, gold, silver, platinum or alloys thereof, or any other suitable material or combination of materials. In at least some embodiments, the first tab 116 and the second tab 118 may be made of the same material as that of the tubular member 102. In at least some embodiments, the first tab 116 and the second tab 118 and the tubular member 102 may be made of different materials.

The actuator 114 can be integrally, e.g., monolithically formed with the tubular member 102. Alternatively, the actuator 114 can be formed separately and coupled to the tubular member 102 using a suitable technique. For example, techniques such as welding, soldering, or the like; adhesives such as poly(glycerol-co-sebacate acrylate), or the like; fasteners such as a pin, screw, or the like, or any other suitable methods or materials can be used to attach the actuator 114 to the tubular member 102. The techniques used to form the tubular member 102 may include injection molding, extrusion or the like.

Additionally, in some embodiments, one or more tensioning elements (schematically illustrated by 107) may be employed to bias the tubular member 102 in the closed position. The tensioning element 107 may be capable of being elongated, and may be biased to return to its original shape when the tension is released. Examples of such tensioning elements may include a spring, tension bands, or the like. The tensioning element 107 may be formed using materials that are elastic, flexible, and strong such that the tensioning element does not break upon actuation. Examples of such materials may include, but are not limited to, polymers such as rubber, silicone or the like; copolymers such as ABA triblock, or the like, or any other suitable elastomeric biocompatible material that is well known in the art. In some embodiments, the tensioning element 107, in the form of a spring, may be made using materials such as stainless steel, titanium, titanium alloys, or any other suitable material.

The tensioning element 107 may bias (schematically illustrated by opposing arrows in FIG. 2) the actuator 114 to keep the tubular member 102 closed, thereby gripping portions of the catheter shaft and/or the balloon in the bore 108 by preventing the tubular member 102 from spontaneously opening when in the closed position. Hence, accidental disengagement of the catheter shaft and/or balloon from the tubular member 102 may be prevented.

In some embodiments, the laterally removable device 100 can be used as a balloon protector such as for drug coated balloons. The laterally removable device 100 can be applied onto and removed laterally from the drug eluting balloon. As the drug coated balloons may have a coating of a drug disposed on the outer surface, the laterally removable device 100 may enable the physician to insert the balloon through the hemostasis valve without directly contacting the balloon. Hence, this may protect the drug coating on the balloon from being hydrolyzed or disrupted during contact with the user.

In such scenarios, the tubular member 102 can be formed using a material to reduce stress/strain applied to the balloon. One example of such a material is a transparent thermoplastic polyamide based on aliphatic and cycloaliphatic blocks, such as Grilamid® TR-55-LX (EMS-Grivory, Switzerland). Also, as the drug coated balloon may come in contact with the inner surface of the tubular member 102, the bore 108 may be formed using lubricious material. In some embodiments, the bore 108 may include a coating of the lubricious material that will not cause damage to the drug coated balloon. The ability of the tubular member 102 to open longitudinally may minimize placement error as well as allow the operator a holding position during placement of the balloon through the hemostasis valve.

FIG. 2 shows a view of the device 100 of FIG. 1 from the flared end 105. In the illustrated embodiment, the device 100 is in a closed state. As shown, the tubular member 102 may include the actuator 114 disposed proximate the hinge region 112. The actuator 114 may include the first tab 116 and the second tab 118 disposed at an acute angle such that the movement of the first tab 116 and the second tab 118 towards each other expands the slit 110 thereby opening the tubular member 102. The device can then be deployed laterally about the catheter shaft.

As shown in FIG. 3, the flared end 105 may include an outward tapering such that an outer diameter of the tubular member 102 increases towards the first end 104. In some embodiments, the flared end 105 may minimize the damage to the balloon while inserting the balloon through the hemostasis valve. In some embodiments, the device 100 may be advanced proximally over the balloon and the flared end 105 may aid in insertion of the balloon within the device 100 and facilitate folding of the balloon.

FIG. 3 shows a side of the device 100 of FIG. 1. In this figure, the device 100 is shown to include a tubular member 102 with a flared end 105 and a tapered end 103 aiding insertion of the balloon through the hemostasis valve. The laterally removable device 100 may be disposed with the tapered end 103 disposed distally such that when advanced over the deflated balloon, the device 100 may be used to insert the deflated balloon into a hemostasis valve.

FIG. 4 is a perspective view of a laterally removable protection/rewrapping device 400 with one or more ribs 420 defined along an inner surface of a bore 408 of tubular member 402. The ribs 420 may be protrusions extending along the longitudinal length of the tubular member 402. The tubular member 402 can be a tube extruded with integral ribs 420 and with a uniform outer diameter. The inner diameter between the ribs 420 may be substantially uniform. In some examples, the ribs 420 may extend into a tapered end 403 of reduced diameter, as shown in FIG. 4. In other examples, the ribs 420 may extend only along the portion of the tubular member 402 having a uniform diameter.

As shown in FIG. 5, the tubular member 402 includes three ribs 420 that are spaced apart around the inner surface of the bore 408. In some embodiments, the ribs 420 may be uniformly spaced. In other embodiments, the ribs may be disposed in any pattern. The tubular member 402 may include one, two, three, four, five, six, or more ribs 420, depending upon various factors such as the desired folding pattern, the shape and size of the balloon and the number and location of electrodes on the balloon. The ribs 420 may be arranged in different configurations. In some embodiments, the ribs 420 may extend substantially straight along the entire longitudinal length of the tubular member 402. In other embodiments, the ribs 420 may extend along part of the length of the tubular member 402. In other embodiments (not shown), the ribs 420 may extend helically along the longitudinal length of the tubular member 402.

Referring back to the FIG. 4, additionally, similarly to the embodiment of FIG. 1, the laterally removable protection/rewrapping device 400 may include an actuator 414 including a first tab 416 and a second tab 418 disposed opposite to a slit 410. The actuator 414 may enable to transition the tubular member 402 between an open and a closed configurations. Once in an open state, the tubular member 402 may be advanced laterally over a deflated balloon such as a drug coated balloon. In other examples, the tubular member 402 may be advanced laterally over a catheter shaft proximal of a balloon and then may be advanced over the deflated balloon by pulling the catheter shaft proximally through the device 400 or pushing the device 400 distally over the catheter and onto the balloon. In other examples, the device 400 may be laterally attached to the catheter shaft distal of a balloon and the device may then be advanced proximally over the balloon. In this example, the flared end 405 may protect and guide the balloon into the device 400. As the balloon (not shown) is inserted into the bore 408 of the device 400, the ribs 420 may form valleys in the balloon, thereby aiding balloon folding. Additionally, the catheter shaft may be twisted or rotated as the balloon is received with the device 400 to further aid in refolding the balloon.

FIG. 6 illustrates a side view of a movable protection/rewrapping device 600. The movable device 600 may include a tubular member 602 having a first end 604 and a second end 606. The tubular member 602 may define an inner lumen such as a bore 608 extending between the first end 604 and the second end 606. The tubular member 602 may be slideable over the catheter shaft from a position at the proximal end of the catheter shaft to a deflated balloon. The device 600 may then be slid in a distal direction over the deflated balloon to fold or rewrap the deflated balloon. The first or proximal end 604 of the tubular member 602 may have an outwardly flared end 605. The second or distal end 606 may have a tapered end 603 with a reduced diameter. The inwardly tapered end 603 of the tubular member 602 may aid insertion of the balloon and device 600 into the hemostasis valve. The outwardly flared end 605 may prevent the device 600 from being inserted completely into the hemostasis valve.

FIG. 7 shows a perspective view of the movable protection/rewrapping device 600 of FIG. 6. The device 600 may include the tubular member 602 defining the bore 608 having an inner surface. The inner surface may be configured to rewrap a deflated balloon. The inner surface may include a number of ribs 620 extending from the first end 604 to the second end 606 similar to the embodiment shown in FIG. 4. In this embodiment, the ribs 620 may extend straight along the longitudinal axis between the first end 604 and the second end 606.

FIG. 8 shows an end view of the movable protection/rewrapping device 600 of FIG. 7 taken from the first end 604. As shown, the tubular member 602 may include the bore 608 defining the inner surface. The ribs 620 are disposed on the inner surface of the bore 608 and extend straight along the longitudinal axis. The ribs 620 are positioned to form valleys of the balloon folds. In this embodiment, the deflated balloon may be folded into a three wing fold. For example, the balloon may have three flaps with the valleys formed by the ribs 620 between adjacent flaps. The device may have an inward taper 603 at the second end 606

FIG. 9 shows a perspective view of a movable protection/rewrapping device 900 with ribs 920 extending helically along the inner surface of the tubular member 902. The device 900 may include a tubular member 902 defining a bore 908 having an inner surface. The inner surface may include a plurality of ribs 920 and is configured to protect and rewrap a deflated balloon. As shown, the ribs 920 may extend helically along the inner surface between the first end 904 and the second end 906. In some embodiments, the user may turn or twist either the device 900 or the catheter shaft to rewrap the balloon. The turning movement may cause the balloon to get wrapped upon the catheter shaft forming folds in the direction of turning.

A view of the protection/rewrapping device 900 from the flared end 905 is shown in FIG. 10. The ribs 920 disposed within the bore 908 along the inner surface of the tubular member 902 may be present along the circumference in the helical pattern. The device 900 may have an inwardly tapered end 903 which may enable easy insertion into the hemostasis valve.

FIG. 11 shows a perspective view of a movable protection/rewrapping device 1100 with ribs 1120 extending helically. The device 1100 may include a tubular member 1102 defining a bore 1108 having an inner surface. The inner surface may include a plurality of ribs 1120 and may be configured to rewrap a deflated balloon. As shown, the ribs 1120 may extend helically along the inner surface between a first end 1104 and second end 1106 of the tubular member 1102.

In some embodiments, the ribs 1120 can be protrusions integrally e.g., monolithically formed with the tubular member. However, in some embodiments, the ribs 1120 may be protrusions formed and disposed within the bore 1108 of the tubular member 1102. In the illustrated embodiment, each rib 1120 may include a channel 1122 extending lengthwise along the rib 1120, as shown in FIGS. 11 and 12. The channel 1122 may be configured to guide the deflated balloon into the desired folding pattern. The channels 1122 may engage flaps in the balloon to further aid in a predetermined folding pattern. The ribs 1120 and channels 1122 may minimize surface area contact between the inner surface of the device 1100 and the deflated balloon.

In some embodiments, a first end 1104 may be tapered or flared outward 1105. The second end 1106 may have an inward taper 1103 which may enable insertion of the balloon and device 1100 into the hemostasis valve. The flared end 1105 may prevent the device 1100 from completely entering the hemostasis valve.

FIG. 12 shows a view of the device 1100 from the flared end 1105. As shown, the ribs 1120 may extend helically along the inner surface of the tubular member 1102 and may include protrusions with channels 1122 disposed along the inner surface. The bore 1108 may have a circular cross-section and is configured to receive the balloon catheter.

In some embodiments, an axially moveable device 600, 900, 1100 such as those illustrated in FIGS. 6-12 may be placed onto a catheter shaft 300 during manufacture prior to either bonding the balloon 340 or a manifold 320 onto the catheter shaft 300. As shown in FIG. 13A, the device 600, 900, 1100 may be initially positioned on the catheter shaft 300 just distal of the strain relief 350. In some embodiments, the strain relief 350, the catheter shaft 300, and/or the device 600, 900, 1100 may have a locking mechanism (not shown) configured to retain the device in position at the proximal end of the catheter shaft until needed.

Another aspect of the disclosure is a method of inserting a balloon catheter through a hemostasis valve to a treatment site within the body using a device 100, 400. In some examples, the device 100, 400 may include a tubular member 102, 402 having a tapered end 103, 403, a bore 108, 408, a longitudinal slit 110, 410, and an actuator 114, 414 configured to expand the slit 110, 410 thereby expanding the device. Once open, the device 100, 400 may be applied laterally onto the balloon with the inwardly tapered end 103, 403 disposed toward the distal end of the balloon. The tapered end 103, 403 may be partially inserted into the hemostasis valve to aid in inserting the balloon through the valve. The device 100, 400 allows the user to grasp the balloon without directly contacting the balloon, thereby protecting the balloon from damage during insertion of the balloon through the hemostasis valve. Any coating such as a drug coating, on the balloon, is also protected by the device 100, 400. In some examples, the balloon may not have sufficient column strength to be advanced into the valve without damaging the balloon. The device 400 may provide the needed column strength as well as protecting the balloon from handling by the user. Once the balloon is fully inserted through the hemostasis valve, the device 100, 400 may be laterally removed from the catheter.

In some examples, insertion of the balloon catheter may include withdrawal of the catheter after inflation and treatment of a first treatment site, refolding or rewrapping the deflated balloon, and reinsertion of the catheter for treatment of a second treatment site. Once a treatment procedure is completed at the first treatment site, the balloon may be deflated and retracted proximally from the first treatment site and through the hemostasis valve. Some treatment procedures involve performing a similar procedure at a second treatment site with the same balloon. In these procedures, the balloon is required to be rewrapped to pass the balloon into a body lumen or vessel through the hemostasis valve. In some procedures the balloon is removed completely from the body and is then reinserted to a different location. After having been inflated and then deflated, the balloon may not return to its initial tightly folded configuration. This may result in damage to the balloon during reinsertion through the hemostasis valve. The device 400, 600, 900, 1100 may aid in refolding or rewrapping the balloon prior to reinsertion, as well as protecting the balloon during handling.

In some embodiments, the rewrapping device 400 may include a tubular member having a bore, one or more ribs disposed within the bore, and a longitudinal slit. Also, the rewrapping device may include an actuator that may allow the slit to expand and the rewrapping device to open and be disposed laterally onto the catheter shaft. Once open, the rewrapping device may be applied laterally onto the catheter shaft at a first position adjacent a proximal end of the balloon. The rewrapping device may then be slid to a second position over the deflated balloon, rewrapping the deflated balloon as the device is moved over the balloon. The device may be twisted or rotated as it is moved over the balloon to aid in rewrapping the balloon.

When properly positioned, the balloon lies within the bore of the rewrapping device. In this regard, the size of the tubular member is chosen such that the balloon is entirely covered by the rewrapping device. The rewrapping device may be used to insert the balloon through the hemostasis valve of the guide sheath. In such a step, a portion of the rewrapping device may be inserted into the valve as the catheter is inserted into the guide sheath. Once the catheter is advanced to a suitable depth, the rewrapping device can be removed laterally by opening using the actuator.

In one example, a device 400 having one or more ribs 420 disposed within the bore 408 may be used to aid in rewrapping a balloon, in addition to providing protection to the balloon. The device 400 may be laterally disposed onto the catheter shaft at a first position adjacent a proximal end of the catheter. The device 400 may then be slid to a second position over the deflated balloon, rewrapping the deflated balloon as the device is moved over the balloon. The ribs 420 may aid in achieving the desired folded configuration by guiding folds or wings of the balloon. Once the device 400 is disposed over the balloon, the device 400 may be used to guide the balloon into the hemostasis valve by inserting the tapered end 403 at least partially into the valve. The device 400 also protects the balloon from damage due to handling. When properly positioned, the balloon lies within the bore of the device. In this regard, the size of the tubular member may be chosen such that the balloon is entirely covered by the device.

In another example, an axially moveable device 600, 900, 1100 may be used to aid insertion of the balloon 340 into a hemostasis valve 360 of a guide sheath. As shown in FIG. 13A, the device 600, 900, 1100 may be mounted on the catheter shaft such that the device may move axially along the catheter shaft 300 between the strain relief 350 and the balloon 340. The device 600, 900, 1100 may then be advanced over the balloon 340. FIG. 13B illustrates the device 600, 900, 1100 disposed over the balloon just proximal of the hemostasis valve 360. The device 600, 900, 1100 may provide protection to the balloon as well as provide a region for the user to grasp when inserting the balloon into the valve 360. In some examples, the balloon may not have sufficient column strength to be advanced into the valve 360 without damaging the balloon. The device 600, 900, 1100 may provide the needed column strength as well as protecting the balloon from handling by the user. In some examples, the balloon may have a drug coating that may also be protected by the device 600, 900, 1100. The user may grasp the device 600, 900, 1100 and insert the distal end thereof partially into the valve 360. An inward taper 603, 903, 1103 at the distal end of the device 600, 900, 1100 may aid in inserting the distal end of the device partially into the valve 360. The balloon catheter 300 may then be fully advanced through the valve 360 into the guide sheath, after which the device 600, 900, 1100 is withdrawn proximally and parked near the strain relief 350.

In procedures involving insertion of the balloon catheter to a first treatment site, inflation of the balloon, treatment, deflation of the balloon and withdrawal of the catheter, followed by rewrapping the balloon for insertion to a second treatment site, the device 600, 900, 1100 may aid in rewrapping the balloon. After withdrawal of the balloon from the valve after the first treatment procedure, the device 600, 900, 1100 may again be slid from its position near the proximal end of the catheter, distally onto the balloon. In some examples, one or more ribs 620, 920, 1120 on an inner surface of the bore 608, 908, 1108 may aid in rewrapping the balloon into the desired folded configuration. The device 600, 900, 1100 may be twisted or rotated as it is advanced onto the balloon to aid in rewrapping the balloon. The device 600, 900, 1100 may again be used to aid in inserting the balloon into the hemostasis valve 360. Upon fully inserting the balloon through the valve 360, the device 600, 900, 1100 is withdrawn proximally and parked near the proximal end of the catheter 300.

The materials that can be used for the various components of the device 100, 400, 600, 900, 1100 (and/or other devices disclosed herein) may include those commonly associated with medical devices. For simplicity purposes, the following discussion makes reference to the device 100. However, this is not intended to limit the devices and methods described herein, as the discussion may be applied to other similar tubular members and/or components of tubular members disclosed herein.

The device 100 and the various components thereof may be made from a metal, metal alloy, polymer (some examples of which are disclosed below), a metal-polymer composite, ceramics, combinations thereof, and the like, or other suitable material. Some examples of suitable polymers may include polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxymethylene (POM, for example, DELRIN® available from DuPont), polyether block ester, polyurethane (for example, Polyurethane 85A), polypropylene (PP), polyvinylchloride (PVC), polyether-ester (for example, ARNITEL® available from DSM Engineering Plastics), ether or ester based copolymers (for example, butylene/poly(alkylene ether) phthalate and/or other polyester elastomers such as HYTREL® available from DuPont), polyamide (for example, DURETHAN® available from Bayer or CRISTAMID® available from Elf Atochem), elastomeric polyamides, block polyamide/ethers, polyether block amide (PEBA, for example available under the trade name PEBAX®), ethylene vinyl acetate copolymers (EVA), silicones, polyethylene (PE), Marlex high-density polyethylene, Marlex low-density polyethylene, linear low density polyethylene (for example REXELL®), polyester, polybutylene terephthalate (PBT), polyethylene terephthalate (PET), polytrimethylene terephthalate, polyethylene naphthalate (PEN), polyetheretherketone (PEEK), polyimide (PI), polyetherimide (PEI), polyphenylene sulfide (PPS), polyphenylene oxide (PPO), poly paraphenylene terephthalamide (for example, KEVLAR®), polysulfone, nylon, nylon-12 (such as GRILAMID® available from EMS American Grilon), perfluoro(propyl vinyl ether) (PFA), ethylene vinyl alcohol, polyolefin, polystyrene, epoxy, polyvinylidene chloride (PVdC), poly(styrene-b-isobutylene-b-styrene) (for example, SIBS and/or SIBS 50A), polycarbonates, ionomers, biocompatible polymers, other suitable materials, or mixtures, combinations, copolymers thereof, polymer/metal composites, and the like. In some embodiments the sheath can be blended with a liquid crystal polymer (LCP). For example, the mixture can contain up to about 6 percent LCP.

Some examples of suitable metals and metal alloys include stainless steel, such as 304V, 304L, and 316LV stainless steel; mild steel; nickel-titanium alloy such as linear-elastic and/or super-elastic nitinol; other nickel alloys such as nickel-chromium-molybdenum alloys (e.g., UNS: N06625 such as INCONEL® 625, UNS: N06022 such as HASTELLOY® C-22®, UNS: N10276 such as HASTELLOY® C276®, other HASTELLOY® alloys, and the like), nickel-copper alloys (e.g., UNS: N04400 such as MONEL® 400, NICKELVAC® 400, NICORROS® 400, and the like), nickel-cobalt-chromium-molybdenum alloys (e.g., UNS: R30035 such as MP35-N® and the like), nickel-molybdenum alloys (e.g., UNS: N10665 such as HASTELLOY® ALLOY B2®), other nickel-chromium alloys, other nickel-molybdenum alloys, other nickel-cobalt alloys, other nickel-iron alloys, other nickel-copper alloys, other nickel-tungsten or tungsten alloys, and the like; cobalt-chromium alloys; cobalt-chromium-molybdenum alloys (e.g., UNS: R30003 such as ELGILOY®, PHYNOX®, and the like); platinum enriched stainless steel; titanium; combinations thereof; and the like; or any other suitable material.

As alluded to herein, within the family of commercially available nickel-titanium or nitinol alloys, is a category designated “linear elastic” or “non-super-elastic” which, although may be similar in chemistry to conventional shape memory and super elastic varieties, may exhibit distinct and useful mechanical properties. Linear elastic and/or non-super-elastic nitinol may be distinguished from super elastic nitinol in that the linear elastic and/or non-super-elastic nitinol does not display a substantial “superelastic plateau” or “flag region” in its stress/strain curve like super elastic nitinol does. Instead, in the linear elastic and/or non-super-elastic nitinol, as recoverable strain increases, the stress continues to increase in a substantially linear, or a somewhat, but not necessarily entirely linear relationship until plastic deformation begins or at least in a relationship that is more linear that the super elastic plateau and/or flag region that may be seen with super elastic nitinol. Thus, for the purposes of this disclosure linear elastic and/or non-super-elastic nitinol may also be termed “substantially” linear elastic and/or non-super-elastic nitinol.

In some cases, linear elastic and/or non-super-elastic nitinol may also be distinguishable from super elastic nitinol in that linear elastic and/or non-super-elastic nitinol may accept up to about 2-5% strain while remaining substantially elastic (e.g., before plastically deforming) whereas super elastic nitinol may accept up to about 8% strain before plastically deforming. Both of these materials can be distinguished from other linear elastic materials such as stainless steel (that can also can be distinguished based on its composition), which may accept only about 0.2 to 0.44 percent strain before plastically deforming.

In some embodiments, the linear elastic and/or non-super-elastic nickel-titanium alloy is an alloy that does not show any martensite/austenite phase changes that are detectable by differential scanning calorimetry (DSC) and dynamic metal thermal analysis (DMTA) analysis over a large temperature range. For example, in some embodiments, there may be no martensite/austenite phase changes detectable by DSC and DMTA analysis in the range of about −60 degrees Celsius (° C.) to about 120° C. in the linear elastic and/or non-super-elastic nickel-titanium alloy. The mechanical bending properties of such material may therefore be generally inert to the effect of temperature over this very broad range of temperature. In some embodiments, the mechanical bending properties of the linear elastic and/or non-super-elastic nickel-titanium alloy at ambient or room temperature are substantially the same as the mechanical properties at body temperature, for example, in that they do not display a super-elastic plateau and/or flag region. In other words, across a broad temperature range, the linear elastic and/or non-super-elastic nickel-titanium alloy maintains its linear elastic and/or non-super-elastic characteristics and/or properties.

In some embodiments, the linear elastic and/or non-super-elastic nickel-titanium alloy may be in the range of about 50 to about 60 weight percent nickel, with the remainder being essentially titanium. In some embodiments, the composition is in the range of about 54 to about 57 weight percent nickel. One example of a suitable nickel-titanium alloy is FHP-NT alloy commercially available from Furukawa Techno Material Co. of Kanagawa, Japan. Some examples of nickel titanium alloys are disclosed in U.S. Pat. Nos. 5,238,004 and 6,508,803, which are incorporated herein by reference. Other suitable materials may include ULTANIUM™ (available from Neo-Metrics) and GUM METAL™ (available from Toyota). In some other embodiments, a superelastic alloy, for example a superelastic nitinol can be used to achieve desired properties.

It is to be understood that even though numerous characteristics of various embodiments have been set forth in the foregoing description, together with details of the structure and function of various embodiments, this detailed description is illustrative only, and changes may be made in detail, especially in matters of structure and arrangements of parts illustrated by the various embodiments to the full extent indicated by the broad general meaning of the terms in which the appended claims are expressed. This may include, to the extent that it is appropriate, the use of any of the features of one example embodiment being used in other embodiments. The invention's scope is, of course, defined in the language in which the appended claims are expressed. 

What is claimed is:
 1. A removable protection device for a balloon catheter, comprising: a tubular member having a first end, a second end, and a bore extending along a length thereof, wherein the tubular member is flared away from the bore at the first end, the tubular member including a slit extending along the length thereof, said slit configured to receive the balloon catheter into the bore of the tubular member, and a hinge region opposite the slit; at least one rib extending in a helical pattern along an inner surface of the bore; and an actuator configured to expand the slit, thereby opening the tubular member.
 2. The device of claim 1, wherein the at least one rib comprises three ribs spaced apart and extending in a helical pattern along the inner surface of the bore.
 3. The device of claim 1, wherein the at least one rib defines a protrusion with a channel extending lengthwise along the protrusion.
 4. The device of claim 1, wherein the actuator includes first and second spaced apart tabs extending radially away from the tubular member, the first and second tabs configured such that movement of the tabs toward each other causes the slit to expand, allowing the device to be placed laterally over a catheter shaft.
 5. The device of claim 1, further comprising a catheter shaft having a proximal end and a distal end, the catheter shaft having a balloon disposed at the distal end, wherein the tubular member is slidably disposed on the catheter shaft adjacent the proximal end of the catheter shaft, the tubular member configured to slide along the catheter shaft and over the balloon in a deflated state, thereby rewrapping the deflated balloon.
 6. The device of claim 1, further comprising one or more tensioning elements configured to contract the slit, thereby closing the tubular member.
 7. A laterally removable protection and/or rewrapping device for a balloon catheter, comprising: a tubular member having a first end, a second end, and a bore extending therebetween, and one or more ribs extending in a helical pattern along the bore, the tubular member having a slit extending from the first end to the second end, said slit configured to receive the balloon catheter into the bore of the tubular member, and a hinge region opposite the slit, the bore having a shaped inner surface configured to rewrap a deflated balloon with two or more folds; and an actuator configured to expand the slit, allowing the tubular member to be inserted laterally over a catheter shaft.
 8. The device of claim 7, wherein the shaped inner surface of the bore includes two or more of said one or more ribs extending in a helical pattern along the bore.
 9. The device of claim 7, wherein the tubular member is flared out from the bore at one or both of the first and second ends.
 10. The device of claim 7, wherein the actuator includes first and second spaced apart tabs extending radially away from the tubular member, the first and second tabs configured such that movement of the tabs toward each other causes the slit to expand, allowing the device to be placed laterally over a catheter shaft.
 11. The device of claim 7, further comprising one or more tensioning elements configured to contract the slit, thereby closing the tubular member.
 12. A system comprising a balloon catheter; and a laterally removable protection and/or rewrapping device for a balloon catheter that comprises (a) a tubular member having a first end, a second end, and a bore extending therebetween, the tubular member having a slit extending from the first end to the second end, said slit configured to receive the balloon catheter into the bore of the tubular member, and a hinge region opposite the slit, the bore having a shaped inner surface configured to rewrap a deflated balloon with two or more folds, and (b) an actuator configured to expand the slit, allowing the tubular member to be inserted laterally over a catheter shaft.
 13. A method of rewrapping a deflated balloon, comprising: expanding and then deflating an expandable balloon on a catheter shaft, the catheter shaft having a proximal end and a distal end, wherein the expandable balloon is disposed on the distal end; moving a device in accordance with claim 1 distally over the catheter shaft and onto the balloon, thereby rewrapping the balloon.
 14. The method of claim 13, wherein the one or more ribs comprise three ribs spaced apart and extending in a helical pattern along the inner surface of the bore.
 15. The method of claim 13, wherein the rewrapping device is slidably disposed on the catheter shaft, wherein moving the rewrapping device includes sliding the rewrapping device from a first position adjacent the proximal end of the catheter to a second position disposed over the balloon.
 16. The method of claim 15, wherein sliding the rewrapping device to the second position disposed over the balloon includes rotating the rewrapping device onto the balloon.
 17. The method of claim 13, wherein moving the rewrapping device includes actuating the tubular member to expand the slit, laterally moving the rewrapping device onto the catheter shaft proximal of the balloon, and sliding the rewrapping device over the balloon.
 18. The method of claim 17, wherein the actuator includes first and second spaced apart tabs extending radially away from the tubular member, the first and second tabs configured such that movement of the tabs toward each other causes the slit to expand, wherein laterally moving the rewrapping device includes moving the first and second tabs toward each other to expand the slit, and then placing the rewrapping device laterally over the catheter shaft.
 19. The method of claim 13, wherein the inner surface of the tubular member is configured to protect the balloon when the tubular member is disposed over the balloon.
 20. The method of claim 13, wherein expanding and then deflating an expandable balloon includes: inflating the balloon and performing a treatment procedure at a first treatment site within a patient; deflating the balloon and withdrawing the balloon proximally to a position outside the patient; moving the rewrapping device onto the balloon thereby rewrapping the balloon; and moving the catheter shaft and balloon back into the patient to a second treatment site. 